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目的通过对内镜下腹盆部髂外动脉与卵巢血管、生殖股神经及腰大肌位置关系的解剖学观测,为内镜下经阴道肾切除术的临床应用提供解剖学依据。方法选取8例成年女性腹盆部标本,在大体解剖后在内镜下进行观测,确定髂外动脉与卵巢血管的交点为内镜下的标志点,测量其与生殖股神经的距离,确定内镜下经阴道肾切除手术通过盆腔后在腹部到达腹膜后间隙的相对安全区域。结果 (1)确立了以卵巢血管与髂外动脉的交点为内镜下手术入路观察的标志点;左右侧卵巢血管束与髂外动脉相交处的角度,左侧为(20.68±3.14)°,右侧为(29.48±2.47)°(;2)交点处与生殖股神经的距离左侧为(11.84±0.80)mm,右侧为(12.60±1.32)mm。结论在卵巢血管与髂外动脉相交平面,在髂外动脉外侧,沿腰大肌的外侧缘进入腹膜后间隙,此范围是一个相对安全区域。
OBJECTIVE: To provide anatomic evidence for clinical application of endoscopic vaginal nephrectomy by anatomical observation of the relationship between the external iliac artery and the ovarian vessels, genital nerve and psoas muscle. Methods Eight abdomen pelvic specimens of adult women were selected and observed under endoscope. The intersection of the external iliac artery and the ovarian blood vessel was marked by endoscopy. The distance from the reproductive femoral nerve was measured, Transvaginal nephrectomy through the pelvis in the abdomen to reach the relative safety of the retroperitoneal space. Results (1) The ovarian artery and the external iliac artery was established as the endoscopic point of observation; the angle between the left and right ovarian vascular bundles and the external iliac arteries was (20.68 ± 3.14) ° (11.84 ± 0.80) mm on the right side and (12.60 ± 1.32) mm on the right side were (29.48 ± 2.47) ° (2). Conclusions In the plane of the intersection of ovarian vessels and external iliac artery, outside the external iliac artery, along the lateral margin of the psoas muscle into the retroperitoneal space, this range is a relatively safe area.